Which activity modifications are used in the treatment of osteogenesis imperfecta (OI)?

Updated: Feb 24, 2020
  • Author: Manoj Ramachandran, MBBS, MRCS, FRCS; Chief Editor: Harris Gellman, MD  more...
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Answer

Physical therapy, in the form of comprehensive rehabilitation programs, should be directed toward improving joint mobility and developing muscle strength. [42] Physiotherapy has become more effective in the postbisphosphonate era because of the decrease in bone fragility and the improved prognosis for standing or walking. Strategies are age-dependent and are aimed at promoting gross motor development and maximizing functional independence. [15]

In early infancy, gentle handling of babies by parents is encouraged to prevent fractures, with frequent positional changes advised to prevent occipital flattening, torticollis, and frog-leg positioning of the hips.

When the infant is crawling, upper-limb mobility is promoted; this is vital for future transfers. Exercises can include propelling a wheelchair or ambulating with walking aids.

When the child starts to stand, walking is encouraged, both as exercise and as a primary or secondary means of mobility. Weightbearing is promoted in the pool, on tricycles, and with walkers. Prone positioning is used to prevent hip flexion contractures; this is aided by strengthening of hip extensors and quadriceps. Bisphosphonates have significantly improved the walking ability of children with severe forms of OI.


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